Rates of women who are opting for preventive mastectomies, such as Angeline Jolie, have increased by an estimated 50 percent in recent years, experts say. But many doctors are puzzled because the operation doesn't carry a 100 percent guarantee, it's major surgery -- and women have other options, from a once-a-day pill to careful monitoring.

So far there have been 16,778 cases of hand, foot and mouth disease this year, the official Xinhua News Agency said, cropping up in areas ranging from the tropical island province of Hainan in the south to Jilin province in the northeast, Yunnan province in the southwest and Inner Mongolia in the north.

The number and scope of cases in recent years, along with the need for increased surveillance, prompted the Health Ministry to enforce the new reporting rules, spokesman Mao Qun'an said.

"This demonstrates our commitment to people's health," Mao said Wednesday at a rare news conference held jointly with the World Health Organization.

Under a mandate that took effect Tuesday, health care providers need to report cases to the ministry within 24 hours.

The outbreaks are the latest headache for authorities as they gear up for this summer's Beijing Olympics. Preparations have already been upset by unrest in Tibet and protests during the global torch run.

Mao insisted there would not be any impact on the games, which begin Aug. 8. Already embassies and foreign schools have sent out notices urging vigilance against the illness.

Hand, foot and mouth disease spreads through contact with saliva, feces, fluid secreted from blisters or mucus from the nose and throat. There is no vaccine or specific treatment, but most children affected by the disease typically recover quickly without problems. It is unrelated to the foot and mouth disease that affects livestock.

Both Mao and WHO China representative Hans Troedsson said they expected more cases of hand, foot and mouth to emerge because of the tighter reporting requirements and because the disease will likely peak with warmer weather in June and July.

Last year, some 80,000 hand, foot and mouth cases were recorded in China, with 17 deaths, Mao said, adding that the figures were likely incomplete because reporting wasn't mandatory then.

In the hardest-hit central province of Anhui, 22 children have died since March. Three fatalities have also been reported in Guangdong province in the south and one in Zhejiang province in the east.

Most of the cases in China have been blamed on enterovirus 71, or EV-71, one of several viruses that cause the illness. EV-71 can result in a more serious form of the disease that can lead to paralysis, brain swelling and sometimes death.

Xinhua reported this week that 10 people had been punished for failing to properly tackle hand, foot and mouth in Anhui. Mao said they had been "criticized" for how they handled the situation but did not give any details.

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